The Danyoung Classification Correlation with The Severity of Allergic Rhinitis and Symptoms Duration
DOI:
10.29303/jbt.v25i4.9974Published:
2025-10-14Downloads
Abstract
The Danyoung classification characterizes progressive endoscopic changes in the nasal mucosa of allergic rhinitis (AR) patients, but its clinical correlation with disease severity and chronicity remains unestablished. This cross-sectional study aimed to determine the association between Danyoung stages (1: hypertrophic, 2: dimple, 3: wrinkled) and AR symptomatology. Fifty AR patients from a tertiary allergy-immunology clinic were enrolled over a six-month period. Data on symptom duration, profile, and ARIA-based severity (intermittent/persistent, mild/moderate-severe) were collected. Nasoendoscopic examination was performed for Danyoung staging. Statistical analysis using chi-square tests demonstrated no significant association between Danyoung stage and symptom duration (p=0.85) or clinical disease severity (p=0.96). The findings indicate that the Danyoung classification, as an objective morphological descriptor, is not a statistically significant predictor of symptom-based AR severity or chronicity in this patient cohort. This suggests that the progression of endoscopic nasal mucosal changes may follow a pathway independent of the clinical parameters defined by ARIA guidelines, limiting its utility as a standalone clinical prognostic tool.
Keywords:
Allergy Rhinitis, Allergy Rhinitis Classification, Danyoung ClassificationReferences
Bjermer, L., Westman, M., Holmström, M., & Wickman, M. C. (2019). The complex pathophysiology of allergic rhinitis: scientific rationale for the development of an alternative treatment option. Allergy, Asthma & Clinical Immunology, 15(1), 24. https://doi.org/10.1186/s13223-018-0314-1
Bonds, R. S., & Midoro-Horiuti, T. (2013). Estrogen effects in allergy and asthma. Current Opinion in Allergy & Clinical Immunology, 13(1), 92–99. https://doi.org/10.1097/ACI.0b013e32835a6dd6
Bousquet, J., Khaltaev, N., Cruz, A. A., Denburg, J., Fokkens, W. J., Togias, A., Zuberbier, T., Baena‐Cagnani, C. E., Canonica, G. W., Van Weel, C., Agache, I., Aït‐Khaled, N., Bachert, C., Blaiss, M. S., Bonini, S., Boulet, L. ‐P., Bousquet, P. ‐J., Camargos, P., Carlsen, K. ‐H., … Williams, D. (2008). Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*. Allergy, 63(s86), 8–160. https://doi.org/10.1111/j.1398-9995.2007.01620.x
Chang, S. (2015). Newly Allergic rhinitis classification by Innovative Endoscopic Diagnostic Method-Danyoung Classification. In HEAD MIRROR JOURNAL (Vol. 1).
Chang, S. (2018). Allergic Rhinitis and DANYOUNG Classification Update-2 by Correlation Analysis with Serum Specific IgE Test.
Kim, D. W., Kim, D.-K., Eun, K. M., Bae, J.-S., Chung, Y.-J., Xu, J., Kim, Y. M., & Mo, J.-H. (2017). IL-25 Could Be Involved in the Development of Allergic Rhinitis Sensitized to House Dust Mite. Mediators of Inflammation, 2017, 1–8. https://doi.org/10.1155/2017/3908049
Naclerio, R. (2010). Pathophysiology of nasal congestion. International Journal of General Medicine, 47. https://doi.org/10.2147/IJGM.S8088
Pawankar, R., Canonica, G. W., Holgate, S. T., Lockey, R. F., & Blaiss, M. (2011). World Allergy Organization (WAO) White Book on Allergy. World Allergy Organisation.
Schuler, C. F., & Montejo, J. M. (2019). Allergic Rhinitis in Children and Adolescents. Pediatric Clinics of North America, 66(5), 981–993. https://doi.org/10.1016/j.pcl.2019.06.004
Seidman, M. D., Gurgel, R. K., Lin, S. Y., Schwartz, S. R., Baroody, F. M., Bonner, J. R., Dawson, D. E., Dykewicz, M. S., Hackell, J. M., Han, J. K., Ishman, S. L., Krouse, H. J., Malekzadeh, S., Mims, J. W., Omole, F. S., Reddy, W. D., Wallace, D. V., Walsh, S. A., Warren, B. E., … Nnacheta, L. C. (2015). Clinical Practice Guideline: Allergic Rhinitis. Otolaryngology-Head and Neck Surgery, 152, S1–S43. https://doi.org/10.1177/0194599814561600
Shargorodsky, J., Garcia‐Esquinas, E., Umanskiy, R., Navas‐Acien, A., & Lin, S. Y. (2017). Household pet exposure, allergic sensitization, and rhinitis in the U.S. population. International Forum of Allergy & Rhinology, 7(7), 645–651. https://doi.org/10.1002/alr.21929
Sharma, K., Akre, S., Chakole, S., & Wanjari, M. B. (2022). Allergic Rhinitis and Treatment Modalities: A Review of Literature. Cureus. https://doi.org/10.7759/cureus.28501
Small, P., Keith, P. K., & Kim, H. (2018). Allergic rhinitis. Allergy, Asthma & Clinical Immunology, 14(S2), 51. https://doi.org/10.1186/s13223-018-0280-7
Tran, N. P., Vickery, J., & Blaiss, M. S. (2011). Management of Rhinitis: Allergic and Non-Allergic. Allergy, Asthma and Immunology Research, 3(3), 148. https://doi.org/10.4168/aair.2011.3.3.148
Zachreini, I., Suprihati, Lubis, M. N. D. L., & Koesoema, A. (2015). Uji Diagnostik Histopatologi untuk Konka Hipertrofiyang Disebabkan Rinitis Alergi dan Rinitis Non-alergi. CDK-228, 42(5).
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